June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Impact of COVID-19 on ocular syphilis in Victoria, Australia
Author Affiliations & Notes
  • Lyndell L Lim
    Centre for Eye Research Australia Ltd, East Melbourne, Victoria, Australia
    The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
  • Sachin Phakey
    Centre for Eye Research Australia Ltd, East Melbourne, Victoria, Australia
  • Footnotes
    Commercial Relationships   Lyndell Lim Roche, Novotech, Code C (Consultant/Contractor), Bayer, Code F (Financial Support), Roche, Bayer, Novartis, Code R (Recipient); Sachin Phakey None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 3579. doi:
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    • Get Citation

      Lyndell L Lim, Sachin Phakey; Impact of COVID-19 on ocular syphilis in Victoria, Australia. Invest. Ophthalmol. Vis. Sci. 2023;64(8):3579.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Prior to the Coronavirus disease 2019 (COVID-19) pandemic, syphilis had reached epidemic levels worldwide, with an associated spike in ocular syphilis. Melbourne, the capital of the state of Victoria, Australia, was subject to one of the longest lockdowns in the world spanning periods in 2020 and 2021. Here we report the impact this had on syphilis infections in Australia, and ocular syphilis presentations in Melbourne.

Methods : Nationwide syphilis infections from January 2017 through to November, 2022 were retrospectively obtained from the National Notifiable Diseases Surveillance System. Ocular syphilis presentations at The Royal Victorian Eye and Ear Hospital during the same period were retrospectively obtained from a hospital admissions database. Syphilis incidence in Australia and ocular syphilis cases in Melbourne were explored descriptively by year and sex.

Results : Syphilis infections in Australia increased from 6380 (25.9 cases per 100,000 people) in 2017 to 8379 (33.1 cases per 100,000 people) in 2019 (Table), but fell in 2020 (n=7399, 28.8 per 100,000) and plateaued in 2021 (n=7751, 30.2 per 100,000). In 2022, without any lockdowns, syphilis infections have started to increase again, with the number of infections already at 7599 (29.3 per 100,000) with December data yet to be reported.

Ocular syphilis trends were similar (Table), with the number of presentations increasing from 11 in 2017 to a peak of 19 in 2019, before falling to 11 and 8 in 2020 and 2021, respectively. However, as with overall syphilis infections, the number of presentations in 2022 are starting to peak again, with 19 already reported through to the start of November.

Of interest, the number of female syphilis infections in Australia (range: 1186-1663) and female ocular syphilis presentations in Victoria (range: 3-5) were relatively stable throughout the study period. Conversely, male syphilis infections (range: 5194-6716) and ocular syphilis presentations (range: 5-14) decreased in 2020 and 2021 during COVID-19.

Conclusions : COVID-19 lockdowns had an impact on syphilis infections and ocular syphilis presentations, particularly in males. Nonetheless, syphilis and ocular syphilis infections were still higher in 2020 than in 2017, and are climbing to peak levels again in 2022. Clinicians should therefore take note that ocular presentations of syphilis are on the rise again.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.



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